Health Information Technology Commons^™

Functional Transcranial Doppler Ultrasound For High Temporal Resolution Measurement Of Lateralization In Visual Memory And Visual Search Cognitive Tasks, B. Hage, M. Alwatban, E. Barney, M. Mills, M. Dodd, E. Truemper, Gregory R. Bashford

Biomedical Imaging and Biosignal Analysis Laboratory

Functional transcranial Doppler ultrasound (fTCD) is a noninvasive sensing modality that measures blood flow velocities in cerebral arteries (CBFV) with high temporal resolution. Few studies have examined the relationship of CBFV change during visual search and visual memory cognitive tasks. Here a protocol to compare lateralization between these two similar tasks using fTCD is demonstrated. Thirteen healthy volunteers were shown visual scenes on a computer and performed visual search and visual memory tasks while CBFV in the bilateral middle cerebral arteries was monitored with fTCD. Each subject completed 40 trials, consisting of baseline, calibration, instruction, and task periods. Lateralization was …

The Development And Application Of An Oncology Therapy-Related Symptom Checklist For Adults (Trsc) And Children (Trsc-C) And E-Health Applications., Arthur R Williams, David D Williams, Phoebe D Williams, Farrokh Alemi, Hosai Hesham, Blaine Donley, Raya Kheirbek

Medicine Faculty Publications

BACKGROUND: Studies found that treatment symptoms of concern to oncology/hematology patients were greatly under-identified in medical records. On average, 11.0 symptoms were reported of concern to patients compared to 1.5 symptoms identified in their medical records. A solution to this problem is use of an electronic symptom checklist that can be easily accessed by patients prior to clinical consultations.

PURPOSE: Describe the oncology Therapy-Related Symptom Checklists for Adults (TRSC) and Children (TRSC-C), which are validated bases for e-Health symptom documentation and management. The TRSC has 25 items/symptoms; the TRSC-C has 30 items/symptoms. These items capture up to 80% of the …

Do Health Sciences Libraries And Librarians Have An Impact On The Cost Of Health Care And Research? A Systematic Review, Margaret E. Henderson, Janet A. Crum, Kathy J. Fatkin, Marie-Marthe Gagnon, Tony Nguyen, Madeleine Taylor, Mark Vrabel

VCU Libraries Faculty and Staff Presentations

Objectives: The team worked on a systematic review to answer the question: Do health sciences libraries and librarians have any measurable (statistically significant) positive impacts on consumer health, the outcomes of medical care, the productivity of biomedical researchers, and the knowledge obtained by graduates of biomedical and health sciences training programs, and at what total cost?

Methods: The team used a Google site to collaborate on the review. A spreadsheet was used to brainstorm keywords and list suggestions for subject headings. Databases searched included: PubMed/MEDLINE, CINAHL, ERIC, LISTA, Cochrane Library, and Web of Science. The team searched grey literature and …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Satisfaction Data Collected By Email And Smartphone For Emergency Department (Ed) Patients: How Do Responders Compare To Non-Responders?, Jeffrey Charles Strickler

MUSC Theses and Dissertations

The University of North Carolina ED developed an electronic survey method (Bivarus) which sends a web-link by email or text to patients. This study evaluated this method by considering differences between the key characteristics (age, gender, disposition, race, ethnicity, and payor classification) of the responders and non-responders to this survey from July to December 2013 (22,750 records). An evaluation of the key characteristics showed no difference related to age and disposition, but differences related to sex, race, ethnicity, and payor classes. This difference could therefore lead to under representation of the patient experience from those populations.

An Association Study Between Adult Blood Pressure And Time To First Cardiovascular Disease, Yongjia Pu

Theses and Dissertations

BACKGROUND: Several studies have demonstrated the association between the time to hypertension event and multiple baseline measurements for adults, yet other survival cardiovascular disease (CVD) outcomes such as high cholesterol and heart attack have been somewhat less considered. The Fels Longitudinal Study (FLS) provides us an opportunity to connect adult blood pressure (BP) at certain ages to the time to first CVD outcomes. The availability of long-term serial BP measurements from FLS also potentially allows us to evaluate if the trend of the measured BP biomarkers over time predicts survival outcomes in adulthood through statistical modeling.

METHODS: When the reference …

Seniors With Diabetes-Investigation Of The Impact Of Semantic Auditory Distractions On The Usability Of A Blood Glucose Tracking Mobile Application, Jose A. Rivera Rodriguez

CCAC Theses and Dissertations

Diabetes is the seventh leading cause of death in the United States. With the population rapidly aging, it is expected that 1 out of 3 Americans will have diabetes by 2050. Mobile devices and mobile applications have the potential to contribute to diabetes self-care by allowing users to manage their diabetes by keeping track of their blood glucose levels. Usability is important for systems that help people self-manage conditions such as diabetes. Age and diabetes-related cognitive decline might intensify the impact of usability issues for the users who need these mobile applications the most. As highlighted by usability researchers, the …

Use Of Robots On Cardiac Surgery, Heath Ashford, Alex Hunter, Connie Phung, Alberto Coustasse

Management Faculty Research

Surgical robots are computer-assisted electromechanical devices that aid surgeons and are designed to replicate human movements into more steady precise motions, giving more accurate and delicate operations. The purpose of this research was to study the evolution of technical features of surgical robots on cardiology to determine technical advantages and barriers of these technologies. In one study out of all 50 patients that had endoscopic atraumatic coronary artery bypass robotic surgery, 49 reported they would recommend the surgery to another. Features make instrument manipulation more intuitive by eliminating the fulcrum effect, which removes the surgeon from twisting and turning in …

The Impact Of Patient Portals On Release Of Information Requests, April Insco

Applied Research Projects

Patient portals are no longer a thing of the past. The government has issued a mandate that all covered entities who are reimbursed under Medicare payments must implement patient portals as a part of the Meaningful Use initiative or suffer penalties. The objective of this study is to review the data to see if there is a decrease in the number of release of information (ROI) requests at facilities that have implemented patient portals. A survey was conducted to determine if there was any change in the number of ROI requests that facilities received prior to implementation of patient portal …

Managing Copy And Paste Functionality In The Electronic Health Record, Tricia Urquhart-Jones

Applied Research Projects

The increased adoption of Electronic Health Records (EHR) has identified a significant need to develop tools to help providers maximize time spent documenting in the EHR. Copy and paste functionality, also known as carrying forward, cut and paste, and cloning, is one of many tools that can help providers save time and has been around longer than computers. A survey of thirteen Health Information Management (HIM) professionals responsible for HIMS functions within an acute care hospital in North Carolina was conducted. The survey response rate was 53%. The data gathered in this research study will add to HIM body of …

Health Information Exchanges And Patient Portals In Behavioral Health, Christine Peterson

Applied Research Projects

We live in an electronic world. Technology is everywhere, including in our healthcare system. With the advent on the electronic health record and the push to meet Meaningful Use, many healthcare organizations have already started using patient portals and sharing information among providers via health information exchanges. There have been roadblocks to successful implantation of patient portals and health information exchanges, one of which is how to handle behavioral health information and would these new technologies be accepted by patients with mental health diagnoses

The Challenges Of Establishing Partners In Health Information Exchange (Hie), Torian Tate

Applied Research Projects

Health information exchange (HIE) has become a focus of the health care industry. The ability to share information electronically between multiple health care providers is thought to be a key ingredient in the creation of a more efficient global health care system. VA Hospital Memphis has significant challenges in regard to HIE. The Virtual Lifetime Electronic Record (VLER) coordinator at the facility has been charged with establishing an HIE system. This requires the coordinator to identify partners to share health information with electronically, obtain buy-in from patients and providers through education, and to promote/market the VLER program facility-wide. The VA …

Electronic Health Record Simulator, Samuel M. Brown

Williams Honors College, Honors Research Projects

The Electronic Health Record Simulator is exactly that; it is meant to simulate an EHR (like those found in hospitals and clinics) for use in an academic setting. Its purpose is to familiarize students with the operation of real-world EHRs in order to better prepare them for the workforce. It allows instructors to create fictional patients (with full lab values), and allows students to fill in information as in a real EHR.

‘‘We Can Wipe An Entire Culture’’: Fears And Promises Of Dna Biobanking Among Native Americans, Roberto Abadie, Kathleen Heaney

Department of Sociology: Faculty Publications

This paper explores Native American perceptions on DNA biobanking. A qualitative study was conducted among self-declared Native Americans living off reservation in two Midwest cities. Findings demonstrate a paradox: Informants maintain strong hopes for the transformative power of gene-based research while voicing very particular social anxieties. Emerging genomic technologies elicit concerns over the potential for genetic stigmatization or discrimination based on race, preventing access to health insurance or employment. Frequently, social anxieties adopt the narrative form of conspiracy theories which portray powerful agents exploiting or abusing a disenfranchised population. We argue that while Native Americans do not have a monopoly …

Mhealth: A Utilization Review By Feature Classification For Sustained Use, Elaine Dunn

MUSC Theses and Dissertations

mHealth is a fast growing segment for healthcare. However, there has been little research into the specific elements of mHealth that can drive continued use for optimization of the potential benefits. The purpose of this case study was to use the Delone and McLean Information System Model as a framework for classification of mHealth functionality and then to review the utilization of those categories over a six month period of time. A sample of 137 pediatric diabetics was reviewed. The activation rate was high at 94.9% indicating an interest in using mHealth. There was higher utilization of system features in …

Building Comprehensive And Sustainable Health Informatics Institutions In Developing Countries: Moi University Experience, Martin C. Were, Abraham Siika, Paul O. Ayuo, Lukoye Atwoli, Fabian Esamai

Internal Medicine, East Africa

Current approaches for capacity building in Health Informatics (HI) in developing countries mostly focus on training, and often rely on support from foreign entities. In this paper, we describe a comprehensive and multidimensional capacity-building framework by Lansang & Dennis, and its application for HI capacity building as implemented in a higher-education institution in Kenya. This framework incorporates training, learning-by-doing, partnerships, and centers of excellence. At Moi University (Kenya), the training dimensions include an accredited Masters in HI Program, PhD in HI, and HI short courses. Learning-by-doing occurs through work within MOH facilities at the AMPATH care and treatment program serving …

Validity And Usability Of A Professional Association’S Web-Based Knowledge Translation Portal: American Physical Therapy Association’S Ptnow.Org, Judith E. Deutsch, Wendy Romney, Jan Reynolds, Tara Jo Manal

All PTHMS Faculty Publications

Background: PTNow.org is an evidence-based, on-line portal created by a professional membership association to promote use of evidence in practice and to help decrease unwarranted variation in practice. The site contains synthesis documents designed to promote efficient clinical reasoning. These documents were written and peer-reviewed by teams of content experts and master clinicians. The purpose of this paper is to report on the content and construct validity as well as usability of the site. Methods: Physical therapist participants used clinical summaries (available in 3 formats--as a full summary with hyperlinks, "quick takes" with hyperlinks, and a portable two-page version) on …

Factors Involved In The Successful Transition To And Subsequent Use Of Electronic Health Records (Ehrs) Systems By Individual And Group-Practice Physicians, Naveen Chandra Kotha

UROP Posters

The use of Electronic Health Records (EHRs) by healthcare professionals has been recommended as a way of improving healthcare quality, patient safety, and workflow efficiency, and lowering costs in the long run. While large hospital systems integrate EHRs into their services, individual and group practice-owning physicians, especially those of specialties and subspecialties, are often left wondering whether they should follow the trend and whether the transition from traditional, paper-chart systems or older EHRs to newer, commercial ones will truly benefit their patients and their practice as a whole. These physicians also often wonder whether benefits such as electronic-prescribing, clinical decision …

Just A “Click” Away From Evidence-Based Online Breast Cancer Information, Advice And Support Provided By A Specialist Nurse: An Ethnonetnographic Study, Cynthia Ann Witney

Theses: Doctorates and Masters

Breast cancer has had, and will continue to have, a devastating impact on the lives of many Australian women, their families, friends and the wider community. The concomitant treatment of this disease places a considerable burden on the health care system and the supporters of the person diagnosed with this disease. While there are many government and non-government organisations that provide treatment and support services for the person with breast cancer, these services are usually provided in person either in the home or at the organisation’s offices. This study extended the information advice and support aspects of these services to …

Cyp2d7 Sequence Variation Interferes With Taqman Cyp2d6 (*) 15 And (*) 35 Genotyping., Amanda K. Riffel, Mehdi Dehghani, Toinette Hartshorne, Kristen C. Floyd, J Steven Leeder, Kevin P. Rosenblatt, Andrea Gaedigk

Manuscripts, Articles, Book Chapters and Other Papers

TaqMan™ genotyping assays are widely used to genotype CYP2D6, which encodes a major drug metabolizing enzyme. Assay design for CYP2D6 can be challenging owing to the presence of two pseudogenes, CYP2D7 and CYP2D8, structural and copy number variation and numerous single nucleotide polymorphisms (SNPs) some of which reflect the wild-type sequence of the CYP2D7 pseudogene. The aim of this study was to identify the mechanism causing false-positive CYP2D6 (*) 15 calls and remediate those by redesigning and validating alternative TaqMan genotype assays. Among 13,866 DNA samples genotyped by the CompanionDx® lab on the OpenArray platform, 70 samples were identified as …

Patterns In Chaplain Documentation Of Assessments And Interventions, A Descriptive Study, Kevin E. Adams

Theses and Dissertations

Abstract

PATTERNS IN CHAPLAIN DOCUMENTATION OF ASSESSMENTS AND INTERVENTIONS, A DESCRIPTIVE STUDY

by Kevin Eugene Adams, MDiv

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2015

Diane Dodd-McCue, D.B.A, Department of Patient Counseling

There is increasing emphasis on the importance of evidence-based care provided by all disciplines in healthcare. The Electronic Health Record (EHR) is becoming the standard for communicating assessments, plans of care, interventions, and outcomes of patient care. The spiritual care literature demonstrates the importance of assessing religious/spiritual needs and resources and developing …

Missing Photos, Suffering Withdrawal, Or Finding Freedom? How Experiences Of Social Media Non-Use Influence The Likelihood Of Reversion, Eric P.S. Baumer, Shion Guha Phd, Emily Quan, David Mimno, Geri K. Gay

Health Services and Informatics Research

This article examines social media reversion, when a user intentionally ceases using a social media site but then later resumes use of the site. We analyze a convenience sample of survey data from people who volunteered to stay off Facebook for 99 days but, in some cases, returned before that time. We conduct three separate analyses to triangulate on the phenomenon of reversion: simple quantitative predictors of reversion, factor analysis of adjectives used by respondents to describe their experiences of not using Facebook, and statistical topic analysis of free-text responses. Significant factors predicting either increased or decreased likelihood of reversion …

This Digital Life: A Neighborhood-Based Study Of Adolescents' Lives Online, Jessica Pater Phd, Andrew D. Miller, Elizabeth Mynatt

Health Services and Informatics Research

In Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems.

In this paper, we present the results of a multi-year study of the social computing practices of 179 adolescents (Mage=12.4 years, SD=1.3; range: 10-14) living in a majority-minority lower-income urban neighborhood in the Southeast U.S. We investigate shifting social media practices using annual surveys and focus groups. We describe participants’ social media use and motivations and show how that use has shifted over time. We show how participants identify social pressures and influences as well as specific behaviors including computer-mediated risky behaviors and self-harm. We discuss …

Cybersecurity Vulnerabilities In Medical Devices: A Complex Environment And Multifaceted Problem, Patricia A.H. Williams, Andrew J. Woodward

Research outputs 2014 to 2021

The increased connectivity to existing computer networks has exposed medical devices to cybersecurity vulnerabilities from which they were previously shielded. For the prevention of cybersecurity incidents, it is important to recognize the complexity of the operational environment as well as to catalog the technical vulnerabilities. Cybersecurity protection is not just a technical issue; it is a richer and more intricate problem to solve. A review of the factors that contribute to such a potentially insecure environment, together with the identification of the vulnerabilities, is important for understanding why these vulnerabilities persist and what the solution space should look like. This …

The Hare And The Hortoise [Sic]: The Potential Versus The Reality Of Etp Implementation, Kyaw Kyaw Htat, Patricia A. H Williams, Vincent Mccauley

Research outputs 2014 to 2021

In a health system increasingly driven by cost constraints, there is a focus on improved electronic transfer of information to support healthcare delivery. One area of healthcare that has moved more quickly than others to achieve this is prescribing in the primary care environment. Whilst the move to electronic transfer of prescriptions has reduced transcription errors, the regulatory environment persists with handwritten signatures. This constraint, whilst addressed slowly with technology solutions, needs support from legislative change. The ultimate step is to have a secure mobile model, which would support the move to a fully-electronic, paperless transaction model.

Research Brief: "The Potential For Health-Related Uses Of Mobile Phones And Internet With Homeless Veterans: Results From A Multisite Survey", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the use of mobile phones among homeless veterans for medical appointment reminders, and other health services provided by healthcare practitioners. In policy and practice, social workers and counselors should determine whether mobile communication would benefit homeless veterans with whom they work and should identify certain barriers to mobile communication that could exist; the VA should expand its mobile notification efforts and look for programs that reduce barriers to regular access to mobile communication. Suggestions for future research include expanding the sample of homeless veterans to include those who are living on the streets or in a …

Innovative Workforce Plan: Recently Graduated Nurses As Super Users For Ehr Implementation In A Multi-Hospital Organization, Katherine L. Bullard

Doctor of Nursing Practice (DNP) Projects

A regional health system’s decision to rapidly implement a new electronic health record (EHR) in order to meet Stage 2 meaningful use requirements led to a need for innovative cost-containment strategies. Tapping the local pool of unemployed newly graduated nurses as half the required super user workforce leveraged the technology skills of novice nurses registered nurses as trainers of experienced nurses in five hospitals. The novel workforce migrated from hospital to hospital, thereby reducing the number of experienced nurses reassigned to super user duties in each hospital. This strategy also reduced the amount of contract labor required to backfill nurse …

Specimen Labeling Improvement Project: Slip, Traci Hoiting

Doctor of Nursing Practice (DNP) Projects

Blood specimens are labeled at the time of acquisition in order to identify and match the specimen, label, and order to the patient. While the labeling process is not new, it is frequently laden with errors (Brown, Smith, & Sherfy, 2011). Wrong blood in tube (WBIT) poses significant risk. Multiple factors contribute to mislabeling errors, including lax policies, limited technological solutions, decentralized labeling processes, multi-tasking, distraction from the clinician, and insufficient education and training of staff. To reduce blood specimen labeling errors, a large academic medical center implemented an innovative technological solution for specimen labeling that integrates patient identification, physician …

Implementing And Evaluating A Clinical Information Interface Between An Electronic Medical Record And A Patient Classification System, Tanya Osborne-Mckenzie

Doctor of Nursing Practice (DNP) Projects

As a result of the Affordable Care Act and the Institute of Medicine’s initiatives, hospitals are challenged to improve outcomes as efficiently as possible. How does the national initiative of RNs partnering with other healthcare professionals to improve the quality of patient care at a lower cost, cascade down to individual organizations? One answer may come by focusing on nurse staffing in acute care hospitals. Considering the impact RNs have on patient quality outcomes and the bottom line of hospitals, appropriate management of the RN workforce is one of the most important areas hospitals can focus on in order to …

Customising Doctor-Nurse Communications, Brian Cusack, Dave Parry

Australian eHealth Informatics and Security Conference

Doctor-Nurse communications are critical for patient safety and workflow effectiveness. Our research question was: What further improvements can be made to current communication systems? A variety of mobile and land based communication systems have been used and experimented with. In the study, the pager was found to be most common and more recent attempts to provide broadband capability with systems such as the iBeep. We built an alternative information system using Android phones and a software application that was customised by feedback from the medical professionals. The trial in five wards with 22 doctors and 170 nurses over one month …